Professional ethics, patient-centred care and cultural competency

PHRM1101 Seminar

Adam La Caze

Professional ethics, patient-centred care and cultural competency

Learning outcomes

  1. Identify ethical decisions and ethical decision-making
  2. Discuss dominant ethical theories
  3. Reflect on what it is to practice pharmacy ethically
  4. Identify and debate pharmacist professional responsibilities in specific contexts
  5. Describe and defend what it means for pharmacists to be socially accountable
  6. Identify and make judgments about patient-centred care
  7. Be able to describe and defend what it means for pharmacists to be culturally competent

What do pharmacists do?

Wylie et al Pharmacoepidemiol Drug Saf 2020

Engagement tasks

  1. Arguments for and against voluntary assisted dying
  2. Discuss pharmacist responsibilities in specific scenarios
  3. Patient-centred care task: Annie, Leanne, Aaron

Discuss dominant ethical theories

  • Do your duty
  • Live well. (Be of good character)
  • Bring about the most good

Which ethical theories were employed to justify Covid-19 response policies?

Which ethical theory provides the best support for pharmacist codes of ethics?

Is it appropriate for pharmacists to refuse to supply emergency contraception?

Engagement task #1: Voluntary assisted dying

What are the arguments for and against voluntary assisted dying?

Describe and defend what it means for pharmacists to be socially accountable

What does it mean to be socially accountable?

Identify and debate pharmacist professional responsibilities in specific contexts

Engagement task #2

  1. Early in the pandemic many people were panic-shopping in pharmacies. This included purchasing multiple salbutamol (reliever) inhalers for asthma. The panic shopping meant that there was a risk that pharmacies would run out of stock of salbutamol.
  1. You dispense pain medicines to an older man with terminal cancer who doesn’t always have a place to sleep. You are concerned that his pain medicines are being stolen from him.
  1. You work in a community that includes people from a number of different cultures. Quite a few people from these cultures express concerns to you about the Covid-19 vaccine.

Reflect on what it is to practice pharmacy ethically

What is patient-centred care?

Provide the best 1–3 word descriptors of patient-centred care

Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions (Institute of Medicine, 2001)

Havi Carel, Illness

Empathy. If I had to pick the human emotion in greatest shortage, it would be empathy. And this is nowhere more evident in illness. The pain, disability and fear are exacerbated by the apathy and disgust with which you are sometimes confronted when you are ill.

Royal Commission into Aged Care Quality and Safety, Interim Report (2019):

We have uncovered an aged care system that is characterised by an absence of innovation and by rigid conformity. The system lacks transparency in communication, reporting and accountability. It is not built around the people it is supposed to help and support, but around funding mechanisms, processes and procedures. This, too, must change.

Patient-centred care engagement task

Cultural competency

Belton, S., Kruske, S., Jackson Pulver, L., Sherwood, J., Tune, K., Carapetis, J., Vaughan, G., Peek, M., McLintock, C., & Sullivan, E. (2018). Rheumatic heart disease in pregnancy: How can health services adapt to the needs of Indigenous women? A qualitative study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 58(4), 425–431. https://doi.org/10.1111/ajo.12744

Discrimination

Cultural competence continuum

Patient-centred labels

Cultural safety

Ahpra Shared Code of Conduct

Any further questions

References

Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US).